Morbus Ahlbäck describes a circulatory disorder in the knee joint. Ahlbäck’s disease usually occurs in women over the age of 60. The therapy includes physiotherapy in an early stage and a partial or total prosthesis in later stages.
What is Ahlbäck’s disease?
Bone necrosis in the knee joint is referred to as Morbus Ahlbäck . Necrosis in the knee is identified by a non-perfused area. Ahlbäck’s disease is not triggered by an infection, but by a circulatory disorder. See nonprofitdictionary for Carpal Tunnel Syndrome (abbreviated as CTS).
As a rule, patients with Ahlbäck’s disease are over 60 years old and female. Men can also be affected by the circulatory disorder. In exceptional cases, Morbus Ahlbäck can occur from the age of ten. If the disease occurs in people up to the age of 20, usually only the cartilage of the knee is affected.
Both mild and severe courses can occur in Ahlbäck’s disease. In the mild course of the disease, the patient notices bone loss or cartilage damage. If the course becomes severe, arthrosis develops in the knee joint. Severe knee necrosis can be accompanied by severe pain, which can be reduced with appropriate therapy.
Ahlbäck’s disease can be triggered by different events. Some of those affected have suffered a circulatory disorder in their knees as a result of an accident. Damage to blood vessels after an accident leads to circulatory disorders.
If the blood circulation in the thigh is disturbed, there is the possibility of developing Ahlbäck’s disease. Taking certain medications can also lead to Morbus Ahlbäck. Long-term use of cortisone can lead to bone necrosis.
The disease is often associated with the long-term consumption of nicotine and alcohol. Blood diseases often lead to the occurrence of Morbus Ahlbäck. In older patients, bone necrosis can also be triggered by incorrect loading of the legs. There are no other triggers for the circulatory disorder in the knee.
Symptoms, Ailments & Signs
Especially at the beginning of the disease, the symptoms can be non-specific. Mild pain in the knee occurs in the mild course of Morbus Ahlbäck. A deep pain in the tissue is characteristic of the circulatory disorder in the knee. The knee of the affected person is usually not very resilient.
Therefore, many people with Ahlbäck’s disease limp when walking. With Morbus Ahlbäck, the pain is always stronger under stress than when at rest. The disease is often confused with damage to the meniscus or a lesion in the cartilage. If you have severe pain in your knee, you should see a specialist as soon as possible.
The specialist checks the knee joint for mobility and any swelling. Pressure pain is also characteristic of Ahlbäck’s disease. If the circulatory disorder in the knee is detected early, the symptoms and consequences of the disease can be reduced.
Diagnosis & course of disease
The diagnosis of Ahlbäck’s disease is made after a comprehensive physical examination. In addition to a stress test of the knee, imaging methods are also used. The circulatory disturbance in the knee can be recognized particularly well by the X-ray.
X -rays show that the affected bone is white. As an alternative to X-rays, there is also the possibility of detecting the disease with magnetic resonance imaging or scintigraphy. A blood test can confirm the suspicion of Ahlbäck’s disease. Patients with a circulatory disorder in the knee usually show a blood clotting disorder in the blood count.
In most cases, Ahlbäck’s disease is not diagnosed directly, since the symptoms are not particularly characteristic and therefore do not speak directly for the disease itself. Those affected primarily suffer from pain in the knees. This often leads to restrictions in movement and also to various restrictions in the patient’s everyday life.
The resilience of those affected decreases and depression and other psychological upsets occur if the pain continues to spread to other regions of the body. Swelling can also occur. Nocturnal pain leads to sleep problems. In many cases, the mobility of the knee is also significantly restricted and reduced. In the worst case, the reduced blood flow can also lead to the death of tissue.
Movement therapy can limit and treat the symptoms of Ahlbäck’s disease relatively well. There are no particular complications, and the patient’s life expectancy is not reduced by the disease. In some cases, implants or prostheses are also necessary to restore the patient’s movement.
When should you go to the doctor?
The risk group for Ahlbäck’s disease includes in particular adult women over 60 years of age. You should consult a doctor at the first irregularities, changes or peculiarities of the general state of health and ask for a clarification of the complaints. Pain in the knee that cannot be attributed to physical exertion or the natural aging process is a warning sign of the organism and must be examined and treated by a doctor. If the pain persists or increases in intensity, a doctor is needed. You should refrain from taking painkillers until you have consulted your doctor, as complications often occur that can be avoided.
A sudden decrease in the usual physical performance, limitations in the usual mobility and everyday movements must be presented to a doctor. Pain on pressure or when touching the knee is a sign of an existing health impairment and should therefore be examined medically.
If the affected person notices a circulatory disorder and cold legs or feet occur, a doctor’s visit is required. A doctor is needed to clarify the cause in the case of disturbances in the sensitivity of the knee, a tingling or numb feeling on the skin and a pale complexion. A significant reduction in symptoms can only be achieved with early diagnosis and treatment.
Treatment & Therapy
Treatment of necrosis of the bone is carried out depending on the severity of the disease. There are several conservative treatment methods that help with Ahlbäck’s disease. As an immediate measure, specialists often recommend resting the affected knee. Movement therapy has also been established for many years.
Medicines that can rebuild your own bones are also often recommended. In the early stages, there is also the possibility of boosting healing through therapy with shock waves or oxygen. This can lead to the growth of new blood vessels in the bone. In the early stages, decompression of the medullary canal can help.
The doctor drills into the bone in question. Drilling stimulates the healing of the bone and the blood vessels can form again. Another option is the use of bone substitutes. If Ahlbäck’s disease is diagnosed at a late stage, implants are often the only treatment option.
The extent of the circulatory disorder is used as an indicator of a suitable therapy. The basic rule is that the smallest implant should always be used. As a result, young people in particular are less restricted in their movement. The surface of the knee joint can be reconstructed with an implant. If the defect is larger, a partial denture is necessary.
The integration of the partial denture is associated with a small amount of bone loss. This means that loss of healthy bone is kept to a minimum. If a large defect was caused by Morbus Ahlbäck, only a complete replacement of the knee joint can help. At every stage of the disease, painkillers and shoe adjustments can also be used.
Outlook & Forecast
No general statements can be made about the prognosis in patients with Ahlbäck’s disease. It depends on the age at which the disease is diagnosed, the course and progress of the disease, and the chosen form of therapy. Without treatment, the prognosis is usually much worse. In the development phase, however, spontaneous healing occasionally occurs.
Despite the prospect of a complete cure, the course of Ahlbäck’s disease is generally lengthy. A concrete prognosis is difficult to assess, especially in young people affected. The conservative treatment of Ahlbäck’s disease using hyperbaric oxygen therapy or shock wave therapy leads to blood vessels growing back into the bones, especially in the early stages. In this way, the disease heals naturally. The extent to which the affected bone can be loaded depends on the specific case. Many sufferers suffer from pain and certain limitations even after the Ahlbäck’s disease has completely healed.
In the case of advanced courses, the insertion of implants is ultimately the most promising in both younger and older patients. Although full mobility is no longer achieved with an artificial knee joint, the disease can be completely cured in this way. The prognosis for standard prostheses is less favorable.
Various precautions can be taken to prevent circulatory disorders in the knee. Since incorrect loading can lead to Ahlbäck’s disease, it is important to ensure correct knee loading.
Losing excess weight is also a preventive measure. In general, avoiding excessive alcohol consumption is recommended to prevent Ahlbäck’s disease. The same applies to the consumption of nicotine. To prevent circulatory disorders in the knee, steroid doping should be avoided.
After successful treatment, Ahlbäck’s disease requires intensive and lengthy follow-up care. The specific measures to be taken depend on the chosen form of therapy. Spontaneous healing rarely occurs in the early stages of the disease. In this case, regular medical check-ups and strict rest are necessary. After surgical treatment of the affected bone, it is particularly important not to put any strain on the leg.
The healing of the surgical scar should also be checked. Intensive follow-up care is necessary when implants or prostheses are used. In this case, the healing of the surgical wound is checked during an inpatient stay in hospital. Afterwards, sometimes longer stays in a rehabilitation clinic are advisable. Depending on the private and professional situation of the patient, these stays can last several weeks or be outpatient.
Basically, follow-up treatment with intensive physiotherapy is necessary in the years after an operation. Orthopedic check-ups are also recommended at regular intervals. In the case of existing pain, there is also the possibility of a stay at a spa many years after the surgical intervention. In a few cases, there are complications that require much more intensive aftercare measures.
You can do that yourself
In younger patients with a not too advanced stage of Ahlbäck’s disease, new cartilage tissue can form and the pain can decrease. If the disease does not develop further, conservative therapy such as protecting the leg with supports and avoiding sports or possibly also adjusting the shoes in the event of a malposition can help. Physiotherapeutic measures to strengthen the leg muscles and to maintain the mobility of the knee joint are recommended. Bone-building drugs promote the ability to regenerate.
Surgical procedures are also used to preserve the joint when the disease has stopped, such as a relief bore, which stimulates the bone tissue to heal itself. A transplant of healthy bone tissue from another part of the body is also a method to replace the destroyed tissue. Hyperbaric oxygen therapy can also be used to support this. Doctor and patient work together to develop an oxygen intake program to promote healing.
In 80 percent of the diseases, however, the destruction of the bone tissue progresses and, if left untreated, leads to increasing pain and ultimately to osteoarthritis of the knee. Although the healing process is quite lengthy, the prognosis is positive if an artificial joint is used. With the support of physiotherapy, the new knee joint is gradually put under more and more stress until the patient can participate in everyday life again without any problems.